Healthcare Provider Details

I. General information

NPI: 1841000809
Provider Name (Legal Business Name): GASTROENTEROLOGY SERVICES OF THE CARIBBEAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2025
Last Update Date: 01/11/2025
Certification Date: 01/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 CALLE AMERICO SALAS STE 401
SAN JUAN PR
00909-2178
US

IV. Provider business mailing address

PO BOX 19647
SAN JUAN PR
00910-1647
US

V. Phone/Fax

Practice location:
  • Phone: 787-919-7865
  • Fax:
Mailing address:
  • Phone: 787-919-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: FEDERICO RODRIGUEZ SERRANO
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-370-8807